Radiofrequency Ablation of Pancreatic Ductal Adenocarcinoma: An Evolving Comrade?

Abstract

Background: Pancreatic ductal adenocarcinoma (PDAC) presents a challenge for the surgeon due to its aggressiveness and to the stagnation of the management options in cases where complete resection is not feasible. Radiofrequency ablation (RFA) in PDAC is described by a few studies as a promising technique. Methods: We present our 12 years' experience in locally advanced unresectable PDAC with a series of 19 patients. The mean age was 66.8 years. The mean tumour diameter was 8.1 cm. In all patients, RFA was performed during laparotomy using Cooltip©, in some with IOUS monitoring, followed by palliative bypass procedures. Results: The postoperative period was relatively uneventful. A repeat CT showed remarkable changes in the size and morphology of the tumour. We observed significant improvement in pain relief. The mean survival with the RFA was 19.3 months (6 -30 months). Conclusions: Our series suggest that RFA for locally advanced and unresectable PDAC in carefully selected patients (excluding multifocal disease) presents a promising, effective and safe associate for the surgeon. RFA plays a complimentary role to current standard palliative therapy, which may prolong survival and improve quality of life. Whether the laparoscopic approach or other non-invasive methods are feasible, will be a challenge for the following years.